Consultant, training and author in behavioral health.

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Silence as Avoidance

I have a client who uses silence as a defense or avoidance. What can I do to make therapy effective when he isn’t engaging with me to work on his goals?

I previously discussed general guidelines about managing silence in session, which will be helpful to read if you didn’t do so before. In this situation, you are experiencing the client’s silence as an obstacle to therapeutic progress and it sounds like he hasn’t responded to your encouragement to work more actively in therapy. I’ll outline a couple suggestions that may help you reframe the meaning of the silence and respond therapeutically.

My first comment is that this client actually is engaging with you through his silence. My guess is that you have spent a lot of mental energy and emotion in attempting to solve what you experience as a problem between you, so he has been successful in creating a relationship with you. The obstacle or problem lies in the fact that he is engaging with you in his preferred way rather than in your preferred way.

A question I would pose is “why does this client prefer to engage with me through silence rather than through talking?” There are a number of possibilities. He may feel vulnerable to being controlled and/or judged by you if he speaks about what he thinks, feels and wants in therapy. He may be sensitive to the implicit power dynamics between the two of you, and using silence to recalibrate the balance of power. He may be highly anxious and/or obsessive, such that his cognitive process becomes paralyzed or blocked when he thinks about painful or unsatisfying aspects of his life. Other explanations may come to mind based what you know of his history and presenting symptoms, if you frame the question in this way.

Once you have developed a hypothesis about the reason he prefers to be silent, you can make a tentative comment like “I wonder if it feels safer to stay silent than to risk hearing what I might say if you were to talk about what is on your mind.” He may or may not respond to this directly or verbally, but communicating your desire and effort to understand him will have a positive effect on the therapeutic alliance.

I would also recommend thinking about your therapeutic role with this client as containing elements of both joining his interpersonal world and providing a different interpersonal experience than is familiar to him. This is always part of the therapeutic process, but the two worlds or experiences are usually closer together than they are in this case.

You may have an assumption that his goals for therapy will be met only if he talks with you as most of your other clients do. Joining his world means letting go of that assumption and meeting him on his terms. This may mean that you remain silent for some of the session or that you comment on his silence without a requirement that he begin talking, as in the example above. In this context, providing a different interpersonal experience may mean that you accept his need for silence without insisting on an explanation. Maybe he has felt forced into interacting with others when he needed distance, and therapy feels like a repetition of that coercion. He will let you know if and when he is ready to engage in a more traditional form of talk therapy. In the meantime, remember that you are demonstrating your capacity to relate to him differently than he may expect and fear.

I hope you this has been helpful in thinking about silence as a defense or avoidance. Please email me with comments, questions or suggestions for future blog topics.